Gap balancing sacrifices joint-line maintenance to improve gap symmetry: a randomized controlled trial comparing gap balancing and measured resection

J Arthroplasty. 2014 May;29(5):950-4. doi: 10.1016/j.arth.2013.09.036. Epub 2013 Oct 1.

Abstract

A total knee arthroplasty can be completed using two techniques; measured resection or gap balancing. A prospective blinded randomized controlled trial was completed with 103 patients randomized to measured resection (n = 52) or gap balancing (n = 51). Primary outcome measure was femoral component rotation. Secondary outcome measures were joint-line change, gap symmetry and function and quality-of-life outcomes. Gap balancing resulted in a significantly raised joint-line compared to measured resection. Gap symmetry was significantly better using gap balancing. Functional outcomes and quality-of-life were not significantly different at 24 months. Using computer navigation, gap balancing significantly raises the joint-line in order to improve gap symmetry. This does not result in a clinical difference in function or quality of life at 24 months.

Keywords: arthroplasty; function; gap balancing; knee; measured resection.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / methods*
  • Female
  • Femur / surgery
  • Humans
  • Joint Diseases / diagnostic imaging*
  • Joint Diseases / surgery*
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery
  • Knee Prosthesis*
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography
  • Rotation
  • Tibia / surgery